NR293 EXAM 1 STUDY GUIDE
• Pharmacology – the study/science of drugs
• Pharmacokinetics – the study of what the body does to a drug
o Absorption
o Distribution – albumin carries protein bound drugs
▪ Albumin is the most prevalent blood protein
o Metabolism – occurs in the liver
▪ Cytochrome P-450 enzyme – responsible for removal of
drugs in the liver
▪ Biotransformation
o Excretion
• Pharmacodynamics – what the drug does to the body
• Pharmacotherapeutics – clinical response of the drug and what its use
is to prevent and treat illnesses
• Adverse effects – reactions
• Six rights to medication administration – patient, time, dose, route,
medication, documentation
• PRN – as needed
• Chemical name – drug composition
• Generic names – given by Adopted Names Council
• Trade name – trademark
• FDA – Food and Drug Administration, implements safety categories
• OTC – over the counter
• Ginkobiloba and St. John’s Wort
o Herbal products
o SJW – used with serotonergic drugs may lead to serotonin
syndrome; patients should inform HCP of all OTC medications as
well as herbal and dietary supplement
o Ginkobiloba – hard on the heart; uses may increase risk for
bleeding in patients with anticoagulants (Warfarin and Heparin)
as well as antiplatelet drugs (Aspirin and Clopidogrel)
• Drug half life – the amount of time it takes for half of the drug to be
excreted out of the body
• Peak level – the highest blood level (too high leads to toxicity)
• Trough level – lowest blood level
• First pass effect – some components of drugs are lost in metabolism in
the liver, if a lot of components are lost the drug has a high first pass
effect (typically PO), IV medications are usually low first pass effect
due to the drug being administered directly into the blood stream
• Educate patients at a 5th grade level
• Pro-drug – (i.e. Tylenol) has to be given and then converted THESE
DRUGS ARE NOT GIVEN IN ACTIVE FORM
• Gram- bacteria are harder to kill because their walls are more complex;
Gram+ are easier to kill because they have smooth membranes and
the drug can pass through easily
• -cidal – kill (i.e. bactericidal)
• -static – inhibit growth (i.e. bacteriostatic)
, • Hospital acquired infection – nosocomial – hand hygiene
• Community acquired infection – caused from the outside world
• Polypharmacy – 5+ medications taken, typically in elderly
• Autonomy – patient can make his or her own decisions (has the right to
refuse)
• Maleficence – harm
• Justice
• Veracity – honesty
• Beneficence – to do no harm
• Lifespan considerations – vary depending on the age group, not all
ages get the same dose/route of medications, different adverse effects
o Drug transfer to the fetus is most likely to occur during the last
trimester of pregnancy
o Neonatal gastric pH is less acidic until 1-2 years of age, gastric
emptying is slowed, and IM absorption is faster and irregular
o Older adult gastric emptying is slower, pH is less acidic,
movement through GI tract because of decreased muscle tone,
blood flow to GI tract is reduced, absorptive surface of GI tract is
reduced
• MRSA – methicillin resistant staphylococcus aureus – treat with
Vancomycin
• VRE – Vancomycin resistant enterococcus
• Empiric therapy - giving a medication before the definite diagnosis,
trying to treat the symptoms
• Definitive therapy – CULTURE FIRST, give antibiotic that is targeted
towards a SPECIFIC bacterium GOLD STANDARD
• Prophylactic – giving a medication before and after a procedure
• Therapeutic effect – decrease signs and symptoms, decrease WBC
(infection), decrease drainage/redness, decrease temperature
• Superinfection – overkill of normal flora (in GI tract and vagina) and
overgrowth of bad flora C. DIFF IS NUMBER ONE SUPERINFECTION *give
probiotics
• Beta Lactam ring – penicillins and cephalosporins are “cousins” – do
not administer a cephalosporin is patient is allergic to penicillins
• Carbapenems – broad spectrum – treat a wide variety of bacterium
• Tetracyclines – NEVER give to children under the age of 8, pregnant
women, NEVER TAKE with Ca, Mg, Ag, Fe (NO ANTACIDS – STAGGER
MEDICATION DOSAGES)
o Tetracycline is a teratogen – binds to Ca and chelates causing
skeletal deformities for fetuses, tooth discoloration in children,
MONITOR FOR PHOTOSENSITIVITY
o Demeclocycline – used to treat SIADH
• Educate patients on the importance of taking the full course of
antibiotics, not just until symptoms stop
• Sulfonamide – drink 2000-3000 mL a day, take with food, monitor RBC
count, take for UTIs (concentrate in the urine)
• Penicillin – take with water only, not juice
• Pharmacology – the study/science of drugs
• Pharmacokinetics – the study of what the body does to a drug
o Absorption
o Distribution – albumin carries protein bound drugs
▪ Albumin is the most prevalent blood protein
o Metabolism – occurs in the liver
▪ Cytochrome P-450 enzyme – responsible for removal of
drugs in the liver
▪ Biotransformation
o Excretion
• Pharmacodynamics – what the drug does to the body
• Pharmacotherapeutics – clinical response of the drug and what its use
is to prevent and treat illnesses
• Adverse effects – reactions
• Six rights to medication administration – patient, time, dose, route,
medication, documentation
• PRN – as needed
• Chemical name – drug composition
• Generic names – given by Adopted Names Council
• Trade name – trademark
• FDA – Food and Drug Administration, implements safety categories
• OTC – over the counter
• Ginkobiloba and St. John’s Wort
o Herbal products
o SJW – used with serotonergic drugs may lead to serotonin
syndrome; patients should inform HCP of all OTC medications as
well as herbal and dietary supplement
o Ginkobiloba – hard on the heart; uses may increase risk for
bleeding in patients with anticoagulants (Warfarin and Heparin)
as well as antiplatelet drugs (Aspirin and Clopidogrel)
• Drug half life – the amount of time it takes for half of the drug to be
excreted out of the body
• Peak level – the highest blood level (too high leads to toxicity)
• Trough level – lowest blood level
• First pass effect – some components of drugs are lost in metabolism in
the liver, if a lot of components are lost the drug has a high first pass
effect (typically PO), IV medications are usually low first pass effect
due to the drug being administered directly into the blood stream
• Educate patients at a 5th grade level
• Pro-drug – (i.e. Tylenol) has to be given and then converted THESE
DRUGS ARE NOT GIVEN IN ACTIVE FORM
• Gram- bacteria are harder to kill because their walls are more complex;
Gram+ are easier to kill because they have smooth membranes and
the drug can pass through easily
• -cidal – kill (i.e. bactericidal)
• -static – inhibit growth (i.e. bacteriostatic)
, • Hospital acquired infection – nosocomial – hand hygiene
• Community acquired infection – caused from the outside world
• Polypharmacy – 5+ medications taken, typically in elderly
• Autonomy – patient can make his or her own decisions (has the right to
refuse)
• Maleficence – harm
• Justice
• Veracity – honesty
• Beneficence – to do no harm
• Lifespan considerations – vary depending on the age group, not all
ages get the same dose/route of medications, different adverse effects
o Drug transfer to the fetus is most likely to occur during the last
trimester of pregnancy
o Neonatal gastric pH is less acidic until 1-2 years of age, gastric
emptying is slowed, and IM absorption is faster and irregular
o Older adult gastric emptying is slower, pH is less acidic,
movement through GI tract because of decreased muscle tone,
blood flow to GI tract is reduced, absorptive surface of GI tract is
reduced
• MRSA – methicillin resistant staphylococcus aureus – treat with
Vancomycin
• VRE – Vancomycin resistant enterococcus
• Empiric therapy - giving a medication before the definite diagnosis,
trying to treat the symptoms
• Definitive therapy – CULTURE FIRST, give antibiotic that is targeted
towards a SPECIFIC bacterium GOLD STANDARD
• Prophylactic – giving a medication before and after a procedure
• Therapeutic effect – decrease signs and symptoms, decrease WBC
(infection), decrease drainage/redness, decrease temperature
• Superinfection – overkill of normal flora (in GI tract and vagina) and
overgrowth of bad flora C. DIFF IS NUMBER ONE SUPERINFECTION *give
probiotics
• Beta Lactam ring – penicillins and cephalosporins are “cousins” – do
not administer a cephalosporin is patient is allergic to penicillins
• Carbapenems – broad spectrum – treat a wide variety of bacterium
• Tetracyclines – NEVER give to children under the age of 8, pregnant
women, NEVER TAKE with Ca, Mg, Ag, Fe (NO ANTACIDS – STAGGER
MEDICATION DOSAGES)
o Tetracycline is a teratogen – binds to Ca and chelates causing
skeletal deformities for fetuses, tooth discoloration in children,
MONITOR FOR PHOTOSENSITIVITY
o Demeclocycline – used to treat SIADH
• Educate patients on the importance of taking the full course of
antibiotics, not just until symptoms stop
• Sulfonamide – drink 2000-3000 mL a day, take with food, monitor RBC
count, take for UTIs (concentrate in the urine)
• Penicillin – take with water only, not juice
